Emergency responses for a health workforce under pressure: Lessons
learned from system responses to the first wave of the pandemic in
Canada
Abstract
The global health workforce crisis, simmering for decades, was brought
to a rolling boil by the COVID-19 Pandemic in 2020. With scarce
literature, evidence, or best practices to draw from, countries around
the world moved to flex their workforces to meet acute challenges of the
pandemic, facing demands related to patient volume, patient acuity, and
worker vulnerability and absenteeism. One early hypothesis suggested
that the acute, short-term pandemic phase would be followed by several
waves of resource demands extending over the longer term. However, as
the acute phase of the pandemic abated, temporary workforce policies
expired and others were repealed with a view of returning to “normal”.
The workforce needs of subsequent phases of pandemic effects were
largely ignored despite our new equilibrium resting nowhere near our
pre-COVID baseline. In this paper, we describe Canada’s early pandemic
workforce response. We report the results of an environmental scan of
the early workforce strategies adopted in Canada during the first COVID
wave of the COVID 19 pandemic. Within a three-part framework for
supporting a sustainable health workforce, we describe 470 strategies
and policies that aimed to increase the numbers and flexibility of
health workers in Canada, and to maximise their continued availability
to work. These strategies targeted all types of health workers and
roles, enabling changes to the places health work is done, the way in
which care is delivered, and the mechanisms by which it is regulated.
Telehealth strategies and virtual care were the most prevalent, followed
by role expansion, licensure flexibility, mental health supports for
workers, and return to practice of retirees. We explore the degree to
which these short-term, acute response strategies might be adapted or
extended to support the evolving workforce’s long-term needs.